Affordable Care Act coverage, costs mostly unchanged for 2018

Despite a year filled with debate among lawmakers about either changing or repealing the Affordable Care Act, most consumers enrolling in marketplace plans this month shouldn’t notice a difference.

Nancy Kelley, director of Missouri Foundation for Health’s Expanding Coverage program, said that despite a lot of discussion among politicians nothing significant has changed.

“The Affordable Care Act, a lot of people call it Obamacare, is the law of the land. And even though there have been several attempts by Congress to repeal and replace, and also a lot of statements and executive orders from the president, actually nothing substantial has changed in terms of enrollment for this year,” Kelley said.

Kelley added that most people do still need insurance or there will be a penalty. Open enrollment for marketplace plans started Nov. 1 and ends Dec. 15 for those seeking coverage in 2018.

Kevin Wehner, Central Missouri Community Action navigator, said there may be some confusion surrounding cost-sharing reductions.

The ACA mandates insurers offer plans that include reduced out-of-pocket costs for people who purchase a silver-level plan and have incomes of 100-250 percent of the poverty level. Those out-of-pocket costs are items like deductibles and copayments. Then, the government compensates insurers for those cost-sharing reductions.

However, President Donald Trump earlier this year said the government would no longer be making cost-sharing payments to insurance companies, calling the payments a bailout.

Wehner said that while the administration is no longer making those payments to insurance companies, the ACA still requires companies provide cost-sharing reductions. That means low-income consumers enrolled in a silver-level plan will still be able to get the cost-sharing reduction discount.

Kelley said tax credits also are available to help lower premiums. She added that there has been concern over premiums increasing, which Kelley said is partially because insurance companies anticipated the cost-sharing reductions might disappear.

“However, the way that it’s set up, the tax credits increase in tandem with that,” she said. “Someone may not see much of an increase because as the premium goes up, so does that tax credit.”

Kelley said some people are only eligible to receive a small tax credit because they are on the higher end of the income range coming into the marketplace. Those consumers could see a significant increase in premiums. She encourages people to shop around.

Kelley said even though someone can sign up until Dec. 15, she doesn’t recommend waiting. She said it’s important for people to give themselves time to consider their plan options.

Thomas Robinson re-enrolled in a health insurance plan on the marketplace Saturday with an expert by his side. Trained staff members with Central Missouri Community Action, Mid-Missouri Legal Services and Primaris were at the Columbia Public Library on Saturday to answer questions and assist with enrollment.

Robinson said he typically makes an appointment to get assistance in enrolling each year in case he has questions.

“They know the difference between the gold, silver and bronze plans,” he said.

Wehner said using a navigator to enroll in coverage can be helpful.

“We have a certain expertise. We are really familiar with all the plans,” Wehner said. “We can help people understand how the plans work and comparing and contrasting the plans and reporting their income for the marketplace.”

Local agencies will be back at the library from 9:30 a.m. to 4 p.m. every Saturday through Dec. 9, and from 9:30 a.m. to noon on the Saturday after Thanksgiving. Help will also be available at the library from 1- 4 p.m. Dec. 6 and 6-8:30 p.m. Dec. 12.

When sitting down to enroll on their own or with a navigator, Wehner recommends people have social security numbers for everyone in their family, a good idea of what their income will be for the next year, a list of their doctors and medicines and either their email account login for those new to the marketplace or healthcare.gov login for those re-enrolling.

mfavignano@columbiatribune.com

573-815-1719

Never miss a story

Choose the plan that's right for you.
Digital access or digital and print delivery.